Co-occurence of risky driving behaviours and associations with seatbelt and helmet use - a descriptive cross-sectional study among young adults

Background: Greece exhibits one of the highest rates of deaths and injuries due to motor vehicle crashes in young adults in Europe. The personal, social and financial cost is still very high as road traffic crashes account for 65.8% of all deaths among young people aged 10-24 years, with prominent gender differences that are not fully explained yet.  Methods: using a descriptive cross-sectional study design, we examined the associations of seatbelt and helmet use with the likelihood of manifesting multiple driving violations (fail to stop at STOP signs, running red traffic lights, driving towards the wrong direction, illegal overtaking, speeding, cellphone use while driving, driving under the influence of alcohol) in a sample of 536 1st year university students in Greece. A ‘Risky Driving Index’ score (RDI) was produced by summing the frequencies of all behaviours (range 0-28).  Results: only 8.8% of the students reported not performing any of the driving violations, whereas 8.6% engaged in all 7 of them when driving (male: 11.5%; female: 1.9%; score>8, male: 31.7%; female: 8.1%). Male, but not female participants, who never used seatbelts and helmets, reported significantly higher RDI scores with evidence of a dose-response effect in the increase. In adjusted logistic regression models, those who never used (vs regular use) seat belt ‘as drivers’ and ‘as rear seat passengers’ had increased odds of being in the higher score category of RDI (OR=5.239 95%CI=1.280-21.441 and OR=6.782 95%CI=1.891-24.324, respectively).  Conclusion: young male drivers and riders, but not their female counterparts, that do not take typical safety measures (seatbelt and helmet use), reported more illegal and risky driving behaviours. Preventive interventions using a gender-informed approach are needed to address co-occurring risk driving behaviours.  &nbsp

Integrated primary health care in Greece, a missing issue in the current health policy agenda: a systematic review

Background: Over the past years, Greece has undergone several endeavors aimed at modernizing and improving national health care services with a focus on PHC. However, the extent to which integrated primary health care has been achieved is still questioned. <br><br> Purpose: This paper explores the extent to which integrated primary health care (PHC) is an issue in the current agenda of policy makers in Greece, reporting constraints and opportunities and highlighting the need for a policy perspective in developing integrated PHC in this Southern European country. <br><br> Methods: A systematic review in PubMed/Medline and SCOPUS, along with a hand search in selected Greek biomedical journals was undertaken to identify key papers, reports, editorials or opinion letters relevant to integrated health care. <br><br> Results: Our systematic review identified 198 papers and 161 out of them were derived from electronic search. Fifty-three papers in total served the scope of this review and are shortly reported. A key finding is that the long-standing dominance of medical perspectives in Greek health policy has been paving the way towards vertical integration, pushing aside any discussions about horizontal or comprehensive integration of care. <br><br> Conclusion: Establishment of integrated PHC in Greece is still at its infancy, requiring major restructuring of the current national health system, as well as organizational culture changes. Moving towards a new policy-based model would bring this missing issue on the discussion table, facilitating further development

Migrant Domestic Workers’ Experiences of Sexual Harassment: A Qualitative Study in Four EU Countries

Sexual harassment against female migrant domestic workers is a public health problem, which remains hidden and largely underreported. The current paper presents the results of a qualitative research study on sexually victimized migrant domestic workers in four European countries (Austria, Cyprus, Greece, and Sweden). The study aimed at exploring the profile and experiences of victimised individuals. Data were gathered via 66 semi-structured interviews with victimised female migrant domestic workers. Key findings of the current study indicate that the victims: (a) were usually undocumented and had low local language skills; (b) identified domestic work as the only way into the labour market; (c) suffered primarily psychological, economic, and social consequences; (d) had poor social support networks; (e) were poorly connected to governmental support services. This is the first study to explore this hidden problem via direct contact with victims. Addressing barriers of migrants’ social integration seems important. Better regulation and monitoring of this low-skilled occupation could minimise risks for vulnerable employees

Midwives’ experiences of cultural competency training and providing perinatal care for migrant women a mixed methods study: Operational Refugee and Migrant Maternal Approach (ORAMMA) project

Abstract: Background: The number of international migrants continues to increase worldwide. Depending on their country of origin and migration experience, migrants may be at greater risk of maternal and neonatal morbidity and mortality. Having compassionate and culturally competent healthcare providers is essential to optimise perinatal care. The “Operational Refugee and Migrant Maternal Approach” (ORAMMA) project developed cultural competence training for health professionals to aid with providing perinatal care for migrant women. This presents an evaluation of ORAMMA training and explores midwives’ experiences of the training and providing care within the ORAMMA project. Methods: Cultural competence was assessed before and after midwives (n = 35) received ORAMMA compassionate and culturally sensitive maternity care training in three different European countries. Semi-structured interviews (n = 12) explored midwives’ experiences of the training and of caring for migrant women within the ORAMMA project. Results: A significant improvement of the median score pre to post-test was observed for midwives’ knowledge (17 to 20, p < 0.001), skills (5 to 6, p = 0.002) and self-perceived cultural competence (27 to 29, p = 0.010). Exploration of midwives’ experiences of the training revealed themes of “appropriate and applicable”, “made a difference” and “training gaps” and data from ORAMMA project experiences identified three further themes; “supportive care”, “working alongside peer supporters” and “challenges faced”. Conclusions: The training improved midwives’ knowledge and self-perceived cultural competence in three European countries with differing contexts and workforce provision. A positive experience of ORAMMA care model was expressed by midwives, however clearer expectations of peer supporters’ roles and more time within appointments to assess the psychosocial needs of migrant women were desired. Future large-scale research is required to assess the long-term impact of the ORAMMA model and training on practice and clinical perinatal outcomes

Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study

Abstract BACKGROUND: Cross-cultural communication in primary care is often difficult, leading to unsatisfactory, substandard care. Supportive evidence-based guidelines and training initiatives (G/TIs) exist to enhance cross cultural communication but their use in practice is sporadic. The objective of this paper is to elucidate how migrants and other stakeholders can adapt, introduce and evaluate such G/TIs in daily clinical practice. METHODS: We undertook linked qualitative case studies to implement G/TIs focused on enhancing cross cultural communication in primary care, in five European countries. We combined Normalisation Process Theory (NPT) as an analytical framework, with Participatory Learning and Action (PLA) as the research method to engage migrants, primary healthcare providers and other stakeholders. Across all five sites, 66 stakeholders participated in 62 PLA-style focus groups over a 19 month period, and took part in activities to adapt, introduce, and evaluate the G/TIs. Data, including transcripts of group meetings and researchers' fieldwork reports, were coded and thematically analysed by each team using NPT. RESULTS: In all settings, engaging migrants and other stakeholders was challenging but feasible. Stakeholders made significant adaptations to the G/TIs to fit their local context, for example, changing the focus of a G/TI from palliative care to mental health; or altering the target audience from General Practitioners (GPs) to the wider multidisciplinary team. They also progressed plans to deliver them in routine practice, for example liaising with GP practices regarding timing and location of training sessions and to evaluate their impact. All stakeholders reported benefits of the implemented G/TIs in daily practice. Training primary care teams (clinicians and administrators) resulted in a more tolerant attitude and more effective communication, with better focus on migrants' needs. Implementation of interpreter services was difficult mainly because of financial and other resource constraints. However, when used, migrants were more likely to trust the GP's diagnoses and GPs reported a clearer understanding of migrants' symptoms. CONCLUSIONS: Migrants, primary care providers and other key stakeholders can work effectively together to adapt and implement G/TIs to improve communication in cross-cultural consultations, and enhance understanding and trust between GPs and migrant patients.The RESTORE project was funded by the EU Seventh Framework Programme (FP7/2007–2013) under Grant Agreement No. 257258. RESTORE: REsearch into Implementation STrategies to support patients of different ORigins and language background in a variety of European primary care setting

Measuring the burden of herpes zoster and post herpetic neuralgia within primary care in rural Crete, Greece

<p>Abstract</p> <p>Background</p> <p>Research has indicated that general practitioners (GPs) have good clinical judgment in regards to diagnosing and managing herpes zoster (HZ) within clinical practice in a country with limited resources for primary care and general practice. The objective of the current study was to assess the burden of HZ and post herpetic neuralgia (PHN) within rural general practices in Crete, Greece.</p> <p>Methods</p> <p>The current study took place within a rural setting in Crete, Greece during the period of November 2007 to November 2009 within the catchment area in which the Cretan Rural Practice-based Research Network is operating. In total 19 GP's from 14 health care units in rural Crete were invited to participate, covering a total turnover patient population of approximately 25, 000 subjects. For the purpose of this study an electronic record database was constructed and used as the main tool for monitoring HZ and PHN incidence. Stress related data was also collected with the use of the Short Anxiety Screening Test (SAST).</p> <p>Results</p> <p>The crude incidence rate of HZ was 1.4/1000 patients/year throughout the entire network of health centers and satellite practices, while among satellite practices alone it was calculated at 1.3/1000 patients/year. Additionally, the standardised incidence density within satellite practices was calculated at 1.6/1000 patients/year. In regards to the stress associated with HZ and PHN, the latter were found to have lower levels of anxiety, as assessed through the SAST score (17.4 ± 3.9 vs. 21.1 ± 5.7; <it>p </it>= 0.029).</p> <p>Conclusions</p> <p>The implementation of an electronic surveillance system was feasible so as to measure the burden of HZ and PHN within the rural general practice setting in Crete.</p

Perceived Knowledge and Attitudes of Faculty Members towards Inclusive Education for Students with Disabilities: Evidence from a Greek University

The current paper aimed at investigating factors affecting the perceptions and attitudes of faculty members towards inclusive education for students with disabilities in a Greek University. A questionnaire, based on the &ldquo;Expanding Cultural Awareness of Exceptional Learners-ExCEL&rdquo; was distributed online to 311 faculty members, during the first semester of 2020. The questionnaire explored participants&rsquo; sociodemographic and academic background, prior training and personal experience with disability, perceived knowledge, beliefs and attitudes towards inclusive education practices. A total of 80 questionnaires were completed (males 56.3%; aged 41&ndash;50 years 43.7%; working experience &gt; 16 years 52.4%; prior training on disability 77.5%). Factor analysis identified four constructs relevant to: (a) perceived knowledge regarding the legal framework (&ldquo;Perceived Knowledge&rdquo;), (b) intention towards the provision of general accommodations in class (&ldquo;Help in Class&rdquo;), (c) intention towards resource provision (&ldquo;Material Offer&rdquo;), and (d) beliefs about the provision of accommodations to students with disabilities (&ldquo;Negative Attitude&rdquo;). Gender, faculty subject and prior training on disability were shown to affect the participants&rsquo; &ldquo;Perceived Knowledge&rdquo;, while working position was shown to affect &ldquo;Material Offer&rdquo;. Age, working experience, and personal experience with disability did not reveal any significant effect. More research is needed to investigate the attitudinal and practical barriers of faculty members towards meeting students&rsquo; educational needs

Is Sexual Assault a Problem in Greek Prisons? Initial Evidence from a Greek Male Prison

This study aimed to explore the problem of inmate sexual victimization in a Greek male prison. A total of 400 individuals were approached in the largest Greek male prison and 50 individuals participated. The questionnaire examined sociodemographic, offence-related information, sexual victimization during incarceration, experiences of witnessing the sexual coercion of other inmates, and history of sexual victimization. Thirteen (26.0%) participants reported sexual victimization by an inmate, including either &ldquo;only non-penetrative&rdquo; or &ldquo;only penetrative ones&rdquo; or &ldquo;both penetrative and non-penetrative&rdquo; ones. The victimized participants also performed worse in child sexual victimization and self-esteem scores as compared with the non-victimized ones. Vulnerable groups identified in the current study could receive further attention in future studies and policy initiatives. Large-scale surveys could be designed to extend our knowledge on this neglected area of research

The Perinatal Journey of a Refugee Woman in Greece: A Qualitative Study in the Context of the ORAMMA Project to Elucidate Current Challenges and Future Perspectives

Migrant and refugee women face specific health risks and challenges during the perinatal period, presenting with complex physical, psychological, and mental health issues. Compassionate antenatal and postnatal care is urgently required across Europe given how outcomes during this period determine the health wellbeing throughout a person’s life. The current study aimed to describe the perinatal health care provided to refugee and migrant women in Greece, as well as to identify the barriers to delivering quality health care to these population groups. Data were gathered via qualitative research, and via document analysis, including grey literature research. Two focus groups were convened; one with five midwives in Athens (representing NGOs in refugee camps and public maternity hospitals) and another in Crete with twenty-six representatives of key stakeholder groups involved in the perinatal care of refugees and migrant women. Desk research was conducted with in a stepwise manner comprising two steps: (a) a mapping exercise to identify organizations/institutes of relevance across Greece, i.e., entities involved in perinatal healthcare provision for refugees and migrants; (b) an electronic search across institutional websites and the World Wide Web, for key documents on the perinatal care of refugee and migrant women that were published during the 10-year period prior to the research being conducted and referring to Greece. Analysis of the desk research followed the principles of content analysis, and the analysis of the focus group data followed the principles of an inductive thematic analysis utilizing the actual data to drive the structure analysis. Key findings of the current study indicate that the socioeconomic status, living and working conditions, the legal status in the host country, as well as providers’ cultural competence, attitudes and beliefs and communication challenges, all currently represent major barriers to the efficient and culturally appropriate provision of perinatal care. The low capacity of the healthcare system to meet the needs of women in these population groups in the context of maternal care in a country that has suffered years of austerity has been amply recorded and adds further contextual constraints. Policy reform is urgently required to achieve cultural competence, to improve transcultural care provision across maternity care settings, and to ensure improved maternal and children’s outcomes

The new map of injuries in the aftermath of the COVID-19 pandemic: examples from north with south Europe

Abstract publicado em: European Journal of Public Health. 2021 Oct;31(Suppl 3):ckab164.662. https://doi.org/10.1093/eurpub/ckab164.663The recent lockdown and containment measures have brought about major changes in the daily routines of people and this resulted in profound changes in the cause of injury (e.g. traffic, falls, interpersonal violence) and nature of injury (e.g. hip fracture, traumatic brain injury). Despite the changes in the aetiologies, injuries remained frequent throughout the pandemic. Evidence from the COVID-19 period suggest a decrease in road traffic crashes, work and leisure injuries and anoteworthy increase in interpersonal violence and self-harm. These different causes and patterns of injury have brought about changes in the clinical characteristics and demand of health services. The aim of this paper is to describe the impact of the pandemic on injuries. Data from National Injury Surveillance System of Norway and Portugal during Covid-19 period were analyzed. In Norway hospital data on injury diagnoses were collected from a national emergency preparedness register established during the pandemic. The number of injured patients per day in the period 1 January-30 June 2020 were identified. The change in patient volumes over two three-week periods before and during the lockdown by sex, age, level of care, level of urgency, type of contact and type of injury were analysed. In Portugal we described the temporal trend in 2020 of the Home and Leisure Accidents(HLA) among vulnerable groups(0-19years, 65years+), who needed attendance in Emergency Department(ED) of the National Health Service Hospitals.info:eu-repo/semantics/publishedVersio